The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Talk to your doctor about your treatment goals and preferences and work together to come up with a treatment plan that is right for you.

Children are more likely to benefit from inhaled medicines if a spacer is used with
metered-dose asthma inhalers. The
University of Arizona
offers a table that compares the different brands of spacers. A study, though, found that there was no difference in how medication was delivered with homemade versus store-bought spacers. Talk to your doctor to find out what is right for you or your child.

Common names of beta-2-agonists (inhalers) include:

Albuterol

Levalbuterol

Pirbuterol

These drugs are bronchodilators, meaning they open the airways by relaxing the muscles around bronchial tubes. This can provide quick relief of acute symptoms. They can also be used as preventive medicines prior to exercise.
You must be careful not to overuse these drugs and contact your doctor right away if your symptoms are not controlled.

Common side effects include:

Fast heartbeat

Headache

Nervousness

Tremor

Ipratropium Bromide

Ipratropium
is a bronchodilator. This is a type of medication that opens up narrowed breathing passages and may decrease mucus secretion.
Tiotropium, a closely related medication, has also been studied for use in patients with asthma. These medications are taken by inhalation to help control the symptoms of lung diseases. Ipratropium and tiotropium help decrease coughing, wheezing, shortness of breath, and troubled breathing by increasing the flow of air into the lungs.

When ipratropium inhalation is used to treat acute, severe attacks of asthma, it is usually used in combination with other bronchodilators. While these drugs are not commonly used to treat asthma except in the emergency room setting, there is some evidence that tiotropium can reduce the need for oral or inhaled corticosteroids in people with very severe and persistent asthma.

Common side effects include:

Cough

Dryness of mouth

Unpleasant taste

Corticosteroids (Oral)

Common names include:

Methylprednisolone

Prednisone

Prednisolone

These drugs are frequently used for a short duration to prevent the progression of moderate or severe symptoms, reverse inflammation, speed recovery, and reduce the risk of relapse. They are not truly rescue medications, but help prolong the effect of beta-2 agonist rescue.

Possible side effects include:

Indigestion

Lowered resistance to infections

Abnormalities in glucose metabolism

Increased appetite

Mood alteration

Fluid retention

Magnesium sulfate (inhaled)

Magnesium sulfate may be helpful in treating adults with acute asthma.

Long-term Control Medications

Long-term “control” medications are used to achieve and maintain long-term management of symptoms and reduce inflammation.

Corticosteroids (Inhaler)

Common names include:

Beclomethasone

Budesonide

Flunisolide

Fluticasone

Mometasone

These drugs suppress, control, and reverse inflammation. They can reduce the need for oral corticosteroids and rescue medication, and play a role in the long-term management of asthma.

Possible side effects include:

Oral thrush

Cough

Corticosteroids (Oral)

Common names include:

Methylprednisolone

Prednisolone

Prednisone

These drugs help reduce inflammation and prevent escalation of symptoms. Oral corticosteroids can produce more side effects than inhaled corticosteroids. Long-term use of oral corticosteroids is not generally recommended. However, your doctor may prescribe oral corticosteroids for long durations only when other treatments have failed to restore normal lung function and the risks of uncontrolled asthma are greater than the side effects of the medication.

These drugs are occasionally used for long-term prevention of symptoms. They may modify inflammation and can be used as preventive treatment prior to exercise.

Possible side effects include:

Unpleasant taste

Cough

Long-acting Beta-2-agonists

Common names include:

Salmeterol

Formoterol

These drugs provide long-term prevention of symptoms, especially nighttime symptoms and are often added to anti-inflammatory therapy such as inhaled corticosteroids. They may also be used as preventive treatment prior to exercise or contact with a known allergen. However, they should not be used during an acute attack.

Possible side effects include:

Rapid heart beat

Tremor

Difficulty sleeping, nervousness

Long-acting inhalers, like salmeterol, may increase the risk of asthma-related death, intubation (putting a tube in the windpipe to breathe), and hospitalization.
This is most likely to occur when they are mistakenly used as rescue inhalers. These medications are almost always prescribed together with an inhaled corticosteroid.
Note
:
If you have any concerns, talk to your doctor.

Methylxanthines

Common names include theophylline.

This type of drug provides long-term control and prevention of symptoms, especially nighttime symptoms. It works by opening the airways and relaxing the muscles around the bronchial tubes. It also increases the ability to clear mucus out of the airway.

Possible side effects include:

Headache

Fast heartbeat

Difficulty with urination

Nervousness

Trouble sleeping

Upset stomach

Leukotriene Modifiers

Zafirlukast

Montelukast

Leukotriene inhibitors are medicines that decrease inflammation by preventing the action of leukotrienes. These types of medications are not used to relieve acute symptoms, but can be used to prevent your symptoms from occurring.

Possible side effects include:

Flu-like symptoms

Nervousness, excitability

Headache

Stomach pain

Cough

Zileuton

Leukotriene blockers are medicines that decrease inflammation by production the action of leukotrienes. Used for long-term control and prevention in mild persistent asthma.

Possible side effects include:

Elevation of liver enzymes

Interactions with other medicines

Immunomodulators

Common names include:

Omalizumab

This is an injected medication that binds to IgE, a type of antibody that contributes to allergic symptoms. These drugs provide long-term control and prevention of symptoms in mild, persistent asthma.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

National asthma education and prevention program expert panel, report 3; Guidelines for the diagnosis and management of asthma 2007. National heart, lung, and blood institute.
Available at: http://www.nhlbi.nih.gov/files/docs/guidelines/asthsumm.pdf. Published October 2007. Accessed August 14, 2015.